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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 - FAX 425-257-8857—www.everettwa.org 1 i —06—)3 <br />/ 2S %Sfh S7 S Cvr z 'acref- ST [ 213 <br />PROJECT ADDRESS <br />Owner Mad Address City State/Zip Phone <br />GACasy <br />Tenant Mail Address City State/Zip Phone <br />SFS 2AIr- &037/ IW2 4t-4vrA� C✓,.,y, /4,6r,.l� G✓ti 9OCLOG2 <br />Electrical Contractor Mail Address City SlatelZip Phone <br />S&-S zA".A-t y90 a -- <br />State License Number Contract Price of Work <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Contact Person (Plan Review) <br />Description of Work to Be Done: =T� e(etTn`rac ca srd r!! Nfa /�Oow�ar lvrv;lorC—_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the some to be Inre and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified heroin or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296 20.0 WAC. _. <br />FEE <br />S� Zo <br />PERMIT# <br />E <br />REVISED "0113 <br />